BMC Cardiovascular Disorders最新文献

{"title":"The association between serum uric acid to high-density lipoprotein cholesterol ratio and heart failure: a cross‑sectional study.","authors":"Zhujun Fang, Zhijie Jiang, Xiaojuan Wang, Xingcai Chen, Yibao Yang","doi":"10.1186/s12872-025-05121-9","DOIUrl":"https://doi.org/10.1186/s12872-025-05121-9","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a disease closely linked to metabolic disorders, and the serum uric acid to high-density lipoprotein cholesterol ratio (UHR) is acknowledged as a potential inflammatory and metabolic marker. However, the association between UHR and HF remains unclear.</p><p><strong>Methods: </strong>This cross-sectional study examined the association between serum UHR and HF in a cohort of 28,169 participants drawn from the National Health and Nutrition Examination Survey (NHANES) 2003-2018 database. Logistic regression analyses, both univariate and multivariate, along with subgroup analyses, were conducted to assess the relationship between UHR and the risk of HF, the robustness of the results, as well as potential influencing factors. Additionally, we also evaluated the nonlinear relationship between UHR and HF using restricted cubic spline analysis.</p><p><strong>Results: </strong>Following the adjustment for all confounding variables, multivariate analysis revealed that LnUHR remained positively correlated with HF (Model 3, OR = 1.82, 95% CI: 1.32-2.52, p < 0.001), with higher LnUHR levels associated with increased risks of HF (Q4 vs. Q1, OR = 1.71, 95% CI: 1.16-2.52, p < 0.01). Subgroup analyses demonstrated that the association between LnUHR and HF stayed stable across most groups. Furthermore, the relationship between LnUHR and HF exhibited a positive nonlinear trend, with an inflection point at 5.52.</p><p><strong>Conclusion: </strong>This study further confirmed that LnUHR is positively associated with HF, emphasizing the potential value of LnUHR as a composite biomarker of HF. Additional large-scale prospective studies are required to validate our findings and clarify underlying mechanisms through further investigation.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"641"},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between the neutrophil-to-lymphocyte ratio with the severity of new-onset coronary artery disease in various glucose metabolic states: a retrospective study.","authors":"Hongyun Shu, Sisi Han, Feng Zhao, Zhihai Xie, Weiping Qiu, Zubing Zhang, Qiaowen Li, Guojun Zhao","doi":"10.1186/s12872-025-05111-x","DOIUrl":"https://doi.org/10.1186/s12872-025-05111-x","url":null,"abstract":"","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"642"},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resuscitated cardiac arrest due to Brugada syndrome in an Ethiopian man: a case report.","authors":"Mehariw Wondim Netsere, Zekarias Seifu Ayalew, Wubalem Belay, Henok Benti, Seifu Bacha, Anteneh Meselu, Asteway Mulat Haile, Kibret Enyew Belay","doi":"10.1186/s12872-025-05102-y","DOIUrl":"https://doi.org/10.1186/s12872-025-05102-y","url":null,"abstract":"","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"638"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbohydrate antigen 125 and clinical outcomes in heart failure: systematic review and meta-analysis.","authors":"Seyed Morteza Pourfaraji, Fatemeh Ojaghi Shirmard, Dorsa Salabat, Danyal Salabat, Zahra Mehdipournamdar, Toshiki Kuno, Anil Harrison, Marc Samsky, Kaveh Hosseini","doi":"10.1186/s12872-025-05141-5","DOIUrl":"https://doi.org/10.1186/s12872-025-05141-5","url":null,"abstract":"<p><strong>Introduction: </strong>Carbohydrate Antigen 125 (CA125) has emerged as a potential biomarker in patients with heart failure (HF). This meta-analysis comprehensively evaluates the association between CA125 levels and clinical outcomes across HF populations.</p><p><strong>Methods: </strong>We conducted this study based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). We systematically searched PubMed, Scopus, Web of Science, and Embase libraries up to April 2025. We selected the original English-language investigations that reported the association between CA125 levels and clinical outcomes in cases with HF. The random-effects model and Hartung-Knapp-Sidik-Jonkman method were used to pool effect sizes and report summary statistics. The current review was registered in PROSPERO (CRD420251023141).</p><p><strong>Results: </strong>A total of 20,458 cases were included from 29 studies, with an average age of 70.3 years, and 36.1% of cases were women. The average cut-off level was 37.78 U/mL, and 35 U/mL was mainly used as the CA125 cut-off level. A meta-analysis of nine studies that reported the risk of experiencing endpoint events (death or HF-related hospitalization) showed significantly higher risk (HR 2.23, 95% CI 1.69-2.93; p < 0.01; I² = 75.0%) among the patients with higher CA125 levels compared to those with lower levels. The increased risk remained significant across the acute heart failure (AHF) (HR based on two studies: 1.88, 95% CI 1.54-2.30; p < 0.01; I² = 39.6%) and chronic heart failure (CHF) (HR based on seven studies: 2.52, 95% CI 1.69-3.77; p < 0.01; I² = 77.4%) subgroups. Furthermore, a correlation meta-analysis of 13 studies revealed a significant direct correlation between CA125 and pro-BNP levels (r = 0.42; 95% CI 0.30 to 0.54; p < 0.01; I² = 96.9%).</p><p><strong>Conclusion: </strong>The current review findings revealed CA125 as a significant prognostic factor of mortality and hospitalization risks in HF population. Furthermore, CA125 could be a non-invasive and operator-independent tool for evaluating disease severity and monitoring response to therapy. We suggested CA125 for monitoring various treatments in individuals with HF, specifically diuretic therapy. Further prospective studies are needed to determine the optimal cut-off for CA125 levels in HF.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"637"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of HARMS₂-AF score with atrial tachyarrhythmia recurrence after radiofrequency catheter ablation: a retrospective observational study.","authors":"Ying Zhu, Meiqi Miao, Zhaochen Xia, Shiyu Liu, Cheng Chang, Licheng Lu, Rong Qian, Jianfeng Qian, Haixiang Xu, Wen Pan, Jianhua Fan","doi":"10.1186/s12872-025-05110-y","DOIUrl":"https://doi.org/10.1186/s12872-025-05110-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and objective: &lt;/strong&gt;Atrial fibrillation (AF) is the most common sustained arrhythmia, with high recurrence rates following radiofrequency catheter ablation (RFCA). Identifying predictors of atrial tachyarrhythmia (Ata) recurrence is crucial for risk stratification and personalized management. The HARMS&lt;sub&gt;2&lt;/sub&gt;-AF score, a novel lifestyle-based risk score comprising hypertension, age, BMI ≥ 30 kg/m², male sex, sleep apnea, smoking, and alcohol consumption, has emerged as a potential predictor for Ata recurrence. This study aimed to evaluate the association between the HARMS&lt;sub&gt;2&lt;/sub&gt;-AF score and Ata recurrence after RFCA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective analysis of 152 patients who underwent RFCA at Kunshan Hospital of Traditional Chinese Medicine between January 2021 and December 2022. Ata recurrence was defined as documented episodes of atrial flutter, atrial tachycardia, or AF lasting more than 30 s on ECG or 24-hour Holter monitorin during follow-up. Based on Ata recurrence, patients were classified into recurrence (n = 44) and non-recurrence (n = 108) groups. Clinical characteristics, CHA&lt;sub&gt;2&lt;/sub&gt;DS&lt;sub&gt;2&lt;/sub&gt;-VASc score, and HARMS&lt;sub&gt;2&lt;/sub&gt;-AF score were compared between the two groups. Spearman's rank correlation analysis was performed to assess the relationships between the HARMS&lt;sub&gt;2&lt;/sub&gt;-AF score, CHA&lt;sub&gt;2&lt;/sub&gt;DS&lt;sub&gt;2&lt;/sub&gt;-VASc score, left atrial diameter (LAD), and Ata recurrence. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of Ata recurrence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients in the recurrence group exhibited a higher prevalence of persistent AF (P = 0.002), larger LAD (P &lt; 0.001), and higher CHA&lt;sub&gt;2&lt;/sub&gt;DS&lt;sub&gt;2&lt;/sub&gt;-VASc (P &lt; 0.001) and HARMS&lt;sub&gt;2&lt;/sub&gt;-AF scores (P &lt; 0.001) compared to the non-recurrence group. Spearman's rank correlation analysis revealed significant positive correlations between the HARMS&lt;sub&gt;2&lt;/sub&gt;-AF score (r = 0.626, P &lt; 0.001), CHA&lt;sub&gt;2&lt;/sub&gt;DS&lt;sub&gt;2&lt;/sub&gt;-VASc score (r = 0.452, P &lt; 0.001), and LAD (r = 0.405, P &lt; 0.001) with Ata recurrence. Multivariate analysis revealed that LAD (OR = 1.280, 95% CI = 1.118-1.464), CHA&lt;sub&gt;2&lt;/sub&gt;DS&lt;sub&gt;2&lt;/sub&gt;-VASc (OR = 3.773, 95% CI = 1.897-7.503), and HARMS&lt;sub&gt;2&lt;/sub&gt;-AF (OR = 3.106, 95% CI = 1.866-5.168) were independent predictors for Ata recurrence after RFCA. The HARMS&lt;sub&gt;2&lt;/sub&gt;-AF score demonstrated high sensitivity (93.2%) and specificity (79.6%) for predicting Ata recurrence. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.895 for HARMS&lt;sub&gt;2&lt;/sub&gt;-AF, 0.777 for CHA&lt;sub&gt;2&lt;/sub&gt;DS&lt;sub&gt;2&lt;/sub&gt;-VASc, and 0.757 for LAD, with HARMS&lt;sub&gt;2&lt;/sub&gt;-AF showing superior predictive accuracy (P = 0.008 vs. CHA&lt;sub&gt;2&lt;/sub&gt;DS&lt;sub&gt;2&lt;/sub&gt;-VASc, P = 0.007 vs. LAD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The HARMS&lt;sub&gt;2&lt;/sub&gt;-AF score is significantly associated with Ata recurrence after RFCA and provides a v","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"636"},"PeriodicalIF":2.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT2 inhibitor reduces atrial tachyarrhythmia recurrence post-cryoballoon ablation: a prospective observational cohort study in patients with and without diabetes.","authors":"Zheng Chen, Lijing Zhang, Fu Chen, Zhonglin Han, Wei Xu","doi":"10.1186/s12872-025-05078-9","DOIUrl":"https://doi.org/10.1186/s12872-025-05078-9","url":null,"abstract":"","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"633"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of peripheral arterial disease and its risk factors, 1990-2021.","authors":"Mengxia Fu, Huan Zhang","doi":"10.1186/s12872-025-05055-2","DOIUrl":"https://doi.org/10.1186/s12872-025-05055-2","url":null,"abstract":"<p><strong>Background: </strong>Lower extremity peripheral arterial disease (PAD) is an atherosclerotic condition affecting the peripheral vasculature, resulting in arterial stenosis or occlusion in the lower limbs. The focus is on understanding the epidemiology of this often-overlooked and debilitating disease.</p><p><strong>Methods: </strong>Data on PAD were retrieved from the GBD 2021. To assess the burden of PAD, we measured prevalence, incidence, disability-adjusted life years (DALYs) and deaths, along with their age-standardized rates (ASRs) per 100,000 person-years.</p><p><strong>Results: </strong>In 2021, the global incidence of PAD cases was 10.0 million (95% UI: 8.7 to 11.1), with an age-standardized incidence rate (ASIR) of 115.4 per 100,000 person-years (95% UI: 100.0 to 132.7). This decreased by 11.3% (95% UI: -11.2 to -11.4) from 1990 to 2021. The global disability-adjusted life years (DALYs) for PAD in 2021 totaled 1.6 million (95% UI: 1.3 to 2.1), with an age-standardized DALYs rate of 18.6 per 100,000 person-years (95% UI: 15.2 to 24.2), reflecting a reduction of 30.1% (95% UI: -31.8 to -28.3) from 1990. The ASIR increased with age, peaking among female aged 75-79 years, with 1015.8 per 100,000 person-years (95% UI: 686.9 to 1425.0) and male aged 95 + . The age-standardized DALYs rate showed minimal variation when the Sociodemographic Index was below 0.6. However, once the SDI exceeded 0.6, a reversed U-shaped relationship emerged. Behavioral and metabolic risks were identified as significant independent risk factors for PAD. By 2050, the global DALYs due to PAD are projected to reach 3.4 million (95% UI: 2.5 to 4.5), and improvements in these risks could reduce DALY counts by 36.6% (95% UI: -36.7 to -36.3).</p><p><strong>Conclusions: </strong>The burden of PAD remains heavy in 2021. The disease is disproportionately diagnosed in females and older adults, highlighting the need for increased awareness and targeted interventions in these populations.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"631"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between noise pollution and cardiovascular diseases: an umbrella review on meta-analyses.","authors":"Samira Tabaei, Sara Rashki Ghalenoo, Maryam Panahandeh, Gholamreza Bagheri, Seyedeh Samaneh Tabaee","doi":"10.1186/s12872-025-04864-9","DOIUrl":"10.1186/s12872-025-04864-9","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) is a global health concern, with established risk factors like smoking, hypertension (HTN), diabetes, and dyslipidemia. Emerging evidence suggests that environmental noise resulting from urbanization and industrialization may contribute to CVD. A comprehensive assessment of existing research is needed to understand the role of environmental noise in cardiovascular health. Following PRISMA guidelines, we conducted a comprehensive literature search across PubMed, Scopus, and Web of Science from inception to 8 May 2025, identifying relevant meta-analyses with specific inclusion and exclusion criteria. Data extraction encompassed study characteristics, exposure-outcome details, and effect estimates. Methodological quality was assessed using the GRADE framework. In our umbrella review of 20 studies, we found that noise pollution is associated with an increased risk of HTN (RR 1.81, 95% CI: 1.51-2.18), atrial fibrillation (RR 1.05, 95% CI: 1.02-1.09), coronary heart disease (RR 1.08, 95% CI: 1.04-1.13), and ischemic heart disease (RR 1.06, 95% CI: 1.03-1.09) per 10-decibel (dB) increase in noise exposure. The exposure-response relationship indicated effects at lower noise levels (50 dB). However, noise exposure did not significantly impact myocardial infarctions (RR 1.02, 95% CI: 1.00-1.05), ischemic heart disease mortality (RR 1.03, 95% CI: 0.99-1.08), or cardiovascular mortality (RR 1.01, 95% CI: 0.98-1.05). We also observed an elevated risk of stroke (RR 1.04, 95% CI: 1.00-1.08) and stroke mortality (RR 1.05, 95% CI: 0.97-1.14). Blood pressure dysregulations (RR 2.55, 95% CI: 1.94-3.36) and ECG abnormalities (RR 2.27, 95% CI: 1.96-2.62) were substantially higher in individuals exposed to noise. Our umbrella review strongly suggests noise exposure as a significant potential risk factor for CVD. The substantial evidence and consistent effect sizes found in our analysis underscore the crucial importance of recognizing noise pollution as a substantial contributor to CVD. With urbanization and industrialization driving increased noise levels, understanding this link is of paramount importance for public health and future research.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"630"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Global burden of atrial fibrillation and atrial flutter due to high alcohol use from 1990 to 2021: estimates from the global burden of disease study 2021.","authors":"Xiaoming Wang, Changzheng Chen, Zhihua Yang, Yu Chen, Jun Fan, Renchun Tang, Yankun Shi, Lixia Yang","doi":"10.1186/s12872-025-05122-8","DOIUrl":"https://doi.org/10.1186/s12872-025-05122-8","url":null,"abstract":"","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"632"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of PCSK-9 inhibitors in patients with acute coronary syndrome: a systematic review and network meta-analysis.","authors":"Guoying Kao, Chuan Chen, Ying Zhang, Yi Xu, Gang Xu","doi":"10.1186/s12872-025-05070-3","DOIUrl":"10.1186/s12872-025-05070-3","url":null,"abstract":"<p><strong>Background: </strong>Acute coronary syndrome (ACS) remains a leading cause of global cardiovascular morbidity and mortality, with elevated low-density lipoprotein cholesterol (LDL-C) being a key modifiable risk factor. Despite statin therapy, many patients fail to achieve optimal LDL-C targets, highlighting the need for adjunctive treatments such as PCSK9 inhibitors (e.g., Evolocumab and Alirocumab). However, comparative evidence on their efficacy and safety in ACS patients remains limited.</p><p><strong>Objective: </strong>To systematically evaluate the efficacy and safety of PCSK9 inhibitors (Evolocumab and Alirocumab) in patients with ACS, focusing on LDL-C reduction and major adverse cardiovascular events (MACE).</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and the WHO International Clinical Trials Registry. Eligible randomized controlled trials (RCTs) assessed PCSK9 inhibitors in ACS patients and reported outcomes on LDL-C and MACE. Both direct and network meta-analyses were performed to compare effect sizes across interventions. No direct head-to-head trials between Evolocumab and Alirocumab were identified.</p><p><strong>Results: </strong>Nine RCTs involving 37,934 patients were included. Direct meta-analysis showed that PCSK9 inhibitors significantly reduced LDL-C (mean difference [MD]: - 52.7 mg/dL; 95% CI: - 61.2 to - 44.1) and lowered the risk of MACE (odds ratio [OR]: 0.79; 95% CI: 0.68-0.93). In subgroup analysis, Evolocumab produced greater LDL-C reductions, while Alirocumab showed a stronger trend toward MACE reduction, though not statistically significant (OR: 0.84; 95% CI: 0.68-1.03). Network meta-analysis confirmed these patterns but revealed no statistically significant differences between the two agents.</p><p><strong>Conclusion: </strong>PCSK9 inhibitors significantly improve lipid profiles and reduce cardiovascular event risk in ACS patients. While Evolocumab and Alirocumab offer similar overall benefits, their differential effects on LDL-C and MACE warrant further investigation. These findings support the role of PCSK9 inhibitors in secondary prevention strategies for high-risk cardiovascular populations.</p>","PeriodicalId":9195,"journal":{"name":"BMC Cardiovascular Disorders","volume":"25 1","pages":"629"},"PeriodicalIF":2.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}